State Investigates Kaiser Kidney Transplant Program
The Department of Managed Health Care has launched an investigation into whether problems in Kaiser Permanente's kidney-transplant program led to unnecessary delays for patients awaiting transplants, the San Francisco Chronicle reports. The department began its investigation five weeks ago after a confidential source provided information about the program, according to DMHC spokesperson Lynne Randolph (Colliver, San Francisco Chronicle, 5/4).
In 2004, Kaiser told more than 1,500 patients on kidney transplant waiting lists in Northern California that it would no longer pay for treatment at outside hospitals. Adult patients were transferred to a new Kaiser transplant center.
During its first full year of operation in 2005, Kaiser performed 56 transplants, but "twice that many people on the waiting list died," according to an analysis by the Los Angeles Times. Delays involving paperwork errors and staff problems contributed to the problems.
The analysis concluded that Kaiser "endangered patients" awaiting kidney transplants by "forcing them into a fledgling program unprepared to handle the caseload" (California Healthline, 5/3).
On Tuesday, Kaiser submitted documents to the department as part of the investigation, which is expected to take about 30 days to complete (San Francisco Chronicle, 5/4).
According to the review by the Times, Kaiser would not authorize the University of California-San Francisco Medical Center to perform transplants for 25 patients who were nearly perfectly matched to offered kidneys.
Kaiser did not properly complete the paperwork to transfer patients from UCSF to the Kaiser facility, but "would not authorize [UCSF] to continue accepting kidneys and transplanting them into Kaiser patients," the Times reports.
The United Network for Organ Sharing, the national group that oversees transplants, said Kaiser's forms to transfer waiting times were full of "errors and inconsistencies."
The 25 kidneys were offered between January and December 2005, according to the California Transplant Donor Network. Organs that are near perfect matches for patients are rare but allow patients to receive a transplant immediately regardless of their position on the waiting list.
The Times investigation "could not determine whether any Kaiser patients died as a direct result of the transition." However, the shift resulted in "hundreds of patients" remaining on dialysis, which "can lead to deadly complications and decrease the chances of a successful transplant later," the Times reports.
Kaiser officials on Wednesday defended the program, noting that no patients at the Kaiser facility died after receiving transplants.
Sharon Levine, associate executive director of the Permanente Medical Group, said that patients' waiting times from other transplant programs were transferred but that the process is complicated. Levine acknowledged staffing issues within the program and said the program is slowly growing. Kaiser will contact the 2,000 patients on its kidney waiting list to answer questions they may have, Levine said (Weber/Ornstein, Los Angeles Times, 5/4).
In addition, Kaiser plans to hire an independent organization to evaluate the program (San Francisco Chronicle, 5/4). Results of that review will be released publicly.
Kaiser officials originally had denied claims that they refused to authorize the UCSF transplants, but after being confronted with information gathered by the Times said they could no longer stand by that position, the Times reports (Los Angeles Times, 5/4).